Your First Choice for a Second Opinion

Have you ever wondered if you should get a second opinion about an orthopedic problem before surgery?  Maybe your inner voice is nudging you about obtaining a second opinion because you’ve doubted a diagnosis?  Have you asked yourself when is getting a second opinion ok?  Well, the answer is unless it is an immediate life-threatening emergency, a second opinion about your medical diagnosis or surgical treatment options is absolutely reasonable.  If a physician seems upset or expresses frustration with you for requesting a second opinion, you should probably take that as a sign that a second opinion is needed. 

Most physicians and surgeons welcome second opinions because they are practicing the best available medical care and willing to stand behind their medical diagnosis and treatment recommendations based on the best available medical standards of care. 

In my 20 years of practicing sports medicine and non-surgical orthopedics, both in South Florida and Portland Oregon, I’ve seen many patients who felt guilty about getting a second opinion and worried that somehow if their physician found out they were getting another opinion, it would offend them.  I was initially surprised at this because many of these patients were considering surgery with recovery that could take months and upend their lives for a prolonged period, or even permanently alter their livelihood if a complication occurred.  While I agree many times with the diagnosis and treatment recommended by other physicians, there are exceptions and instances where it was likely someone who was told “nothing can be done” or they “must have surgery;” could do very well with a specific type of treatment or avoid surgery all together.

Recently, I saw an active 70-year-old patient who has been suffering with pain along the front of her right ankle for over 2 years.  The pain makes it hard for her to drive, walk short distances, and maneuver the pedals on her piano.  She states she no longer enjoys walking on the beach because of her pain.  She has tried several treatments for her ankle problem over the past couple years including bracing, a walking boot, medications, physical therapy, and was told “nothing more can be done, and she should just live with it until she can’t live with it any longer.”  Based on her frustration and the persistent nudging of her friend, she came to see me about her chronic ankle pain.   When she came to see me, she had a particular type of large leg brace known as an ankle foot orthosis (AFO) sticking out of her sneaker.   This brace is commonly used for individuals with foot weakness known as a foot drop to help keep them from tripping and falling.  However, she had normal strength and no evidence of a foot drop on exam.  She did have pain and swelling along a tendon that runs down the front of her ankle and helps with flexing the foot upwards. This tendon was noticeably swollen compared to the same tendon on her left ankle.  On ultrasound imaging, it was evident that her ankle tendon showed moderate to severe tendinopathy and had a moderate size calcification contributing to her pain.  Even though the AFO may have seemed like a good idea, it was actually making her problem worse by reducing motion and contributing to the stenosing effect of the tendon. 

Upon determining the cause of her chronic pain and limitations, I was able to encourage the patient that this can be treated and she can soon be driving, playing the piano, and walking on the beach normally again.  Utilizing a minimally invasive percutaneous procedure to break up the calcification, scar tissue, and lavage it out, we can help facilitate tendon repair and her body replace the damaged collagen affecting the tendon with healthy new tendon tissue.  Though full recovery could take several months, she would likely be feeling better and tolerating more activity she enjoys much sooner. 

If you are looking for a medical second opinion about an orthopedic injury, sports injury, or other musculoskeletal concern, make Sports Health Northwest your first choice for a second opinion.   At Sports Health Northwest, our team wants to utilize 20 years of experience diagnosing and treating difficult orthopedic and sports related conditions to help you have less pain and get back to the activities you enjoy. 

Author

David Westerdahl MD FAAFP RMSK Sports Medicine Physician and owner Sports Health Northwest, Inc.